Researchers at the German Diabetes Center (DDZ), the Research Institute at the Diabetes Academy Mergentheim (FIDAM) and the German Center for Diabetes Research (DZD ) have discovered that chronic inflammatory processes significantly influence the success of treatment for depressive symptoms in people with diabetes. However, the effects differ significantly between type 1 and type 2 diabetes, which opens up new approaches for individualized treatments.

Chronic inflammation is considered to be a biological background mechanism for both diabetes and depression, which occur more frequently than average in diabetics and impair quality of life and the course of the disease. In a study funded by the German Research Foundation, the researchers analyzed data from 521 people with type 1 or type 2 diabetes who took part in three behavioral therapy intervention studies. Over the course of a year, 76 inflammatory markers in the blood and depression symptoms were recorded using a standardized questionnaire in order to investigate the correlation between inflammation levels and changes in the severity of depression.

The results show clear differences: in type 2 diabetes, higher inflammation levels led to a greater improvement in depressive symptoms through behavioral therapy, particularly in cognitive-affective complaints and joylessness. In type 1 diabetes, on the other hand, therapy success was lower with high inflammation levels, especially for somatic symptoms such as fatigue or sleep disorders. The reasons for these differences are still unclear, but could be related to different immune processes – autoimmune reactions in type 1 and metabolic inflammation in type 2.

The findings point to a more precise choice of therapy: People with type 2 diabetes and high levels of inflammation might particularly benefit from cognitive behavioral therapy, while anti-inflammatory drug approaches might be more effective in type 1 diabetes. Further studies should clarify the underlying mechanisms and investigate the role of combined psychotherapeutic and anti-inflammatory treatments in order to make the treatment of depression in diabetes more individualized and effective.

Original Paper:

Biomarkers of inflammation and improvement in depressive symptoms in type 1 and type 2 diabetes: differential associations with depressive symptom clusters | Diabetologia

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